Robert Edwards and his obstetrician colleague Patrick Steptoe, who died in 1988, announced the birth of Louise Brown, the first IVF baby, on 25 July 1978. Since then, 4 million babies have been born thanks to IVF, and the method has become routine worldwide, accounting for 2 to 3 per cent of all births.

Yet at the time, Edwards and Steptoe had to fight widespread hostility. Throughout their quest to develop IVF they faced opposition from religious leaders who expressed moral outrage, from politicians keen to reduce the world's population, and from scientists who warned that the technique would be unsafe. Their request for key funding was denied by the UK's Medical Research Council, and only succeeded thanks to a rich donor whose identity remains a secret.

Fierce opposition

"He developed IVF in the face of so much hostility," says Allan Pacey, an authority on IVF at the University of Sheffield, UK. "Most of us in the profession take our hats off to him for his tenacity, and for keeping going where most of us would have given up."

"Bob's work has always been controversial but he has never shrunk from confronting that controversy," says Martin Johnson, professor of reproductive sciences at the University of Cambridge and author of a recent paper detailing what led the MRC to refuse funding for Edwards's work. "The Nobel has come so late, but he is delighted. This is the cherry on the cake for him," Johnson says.

The panel at the Karolinska Institute in Sweden that awards the prize, was in no doubt about the profound significance of Edwards's achievement. "By a brilliant combination of basic and applied medical research, Edwards overcame one technical hurdle after another in his persistence to discover a method that would help to alleviate infertility," says its citation.

"This discovery represents a monumental medical advance that can truly be said to confer the 'greatest benefit to mankind'," it continues. "Human IVF has radically changed the field of reproductive medicine."

Cure for infertility

Edwards began seeking a cure for infertility, which is a problem for 10 per cent of all couples, in the 1950s. His aim from the outset was to find a way of fertilising human eggs outside the body then returning them to the womb.

He clarified how human eggs mature, which hormones make it happen and at which point in egg development fertilisation with sperm is most likely.

In 1965, he demonstrated for the first time that he could make oocytes mature in vitro to the point where they could be fertilised with sperm. But these fertilised eggs never progressed beyond the two-cell stage, well short of the eight-cell embryo needed for re-implantation.

Edwards decided the solution would be to extract and fertilise oocytes that had already matured in the ovary prior to ovulation. But this involved surgery and removal of part of the ovary, which hugely complicated the procedure.

Keyhole technique

That led Edwards to join forces in the late 1960s with Patrick Steptoe, who had pioneered the technique of laparoscopy at the Oldham and District General Hospital in north-west England. Steptoe's "keyhole surgery" technique made it possible to extract mature eggs from a woman's ovary.

By 1970, Edwards had succeeded in producing eight-cell embryos. But more than 100 attempts to produce babies by re-implanting the embryos in the woman all resulted in miscarriages. In 1976, Edwards realised that this was happening because a hormone given to the women beforehand to stimulate egg maturation later interfered with the pregnancy itself.

Instead, Edwards and Steptoe relied on the woman's natural menstrual cycle to get the eggs to mature, and used the concentration of luteinising hormones in her urine as a marker for when the had occurred. This set the stage for the birth of Louise Brown.

Edwards and Steptoe then set up the Bourn Hall Clinic for IVF in Cambridge, and by 1986, had achieved a further 1000 IVF births.

Since then, the technique has been adopted worldwide, egg and embryo freezing has become routine, and techniques to help infertile men, such as intra-cytoplasmic sperm injection, have become commonplace.

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